Meal Planning with Diabetes Exchanges

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What do I need to know about diabetes exchanges?

Exchanges are servings of food that contain similar amounts of carbohydrate, fat, protein, and calories within a food group. The exchanges can be used to develop a healthy meal plan that helps to keep your blood sugar within the recommended levels. A meal plan with the right amount of carbohydrates is especially important. Your blood sugar naturally rises after you eat carbohydrates. Too many carbohydrates in 1 meal or snack can raise your blood sugar level. Carbohydrates are found in starches, fruit, milk, yogurt, and sweets.

How do I create a meal plan with exchanges?

A dietitian will work with you to develop a healthy meal plan that is right for you. This meal plan will include the amount of exchanges you can have from each food group throughout the day. Follow your meal plan by keeping track of the amount of exchanges you eat for each meal and snack. Your meal plan will be based on your age, weight, blood sugar levels, medicine, and activity level.

What are the starch food group exchanges?

Each exchange below contains about 15 grams of carbohydrate , 3 grams of protein, 1 gram of fat, and 80 calories.

• 1 ounce of white, whole wheat or rye bread (1 slice)
• 1 ounce of bagel (about ¼ of a bagel)
• 1 6-inch flour or corn tortilla or 1 4-inch pancake (about ¼ inch thick)
• ⅓ cup of cooked pasta or rice
• ¾ cup of dry, ready-to-eat cereal with no sugar added
• ½ cup of cooked cereal, such as oatmeal
• 3 graham cracker squares or 8 animal crackers
• 6 saltine-type crackers
• 3 cups of popcorn or ¾ ounce of pretzels
• Starchy vegetables and cooked legumes:
  • ½ cup of corn, green peas, sweet potatoes, or mashed potatoes
  • ¼ of a large baked potato
  • 1 cup of acorn, butternut squash, or pumpkin
  • ½ cup of beans, lentils, or peas (such as pinto, kidney, or black-eyed)
  • ⅔ cup of lima beans

What are the fruit group exchanges?

Each exchange contains about 15 grams of carbohydrate and 60 calories.

• 1 small (4 ounce) apple, banana orange, or nectarine
• ½ cup of canned or fresh fruit
• ½ cup (4 ounces) of unsweetened fruit juice
• 2 tablespoons of dried fruit

What are the milk group exchanges?

Each exchange contains about 12 grams of carbohydrate and 8 grams of protein. The amount of fat and calories in each serving depends on the type of milk (such as whole, low-fat, or fat-free).

• 1 cup fat-free or low-fat milk
• ¾ cup of plain, nonfat yogurt
• 1 cup fat-free, flavored yogurt with artificial (no calorie) sweetener

What are the non-starchy vegetable group exchanges?

Each exchange contains about 5 grams of carbohydrate , 2 grams of protein, and 25 calories. Examples include beets, broccoli, cabbage, carrots, cauliflower, cucumber, mushrooms, tomatoes, and zucchini.

• ½ cup of cooked vegetables or 1 cup of raw vegetables
• ½ cup of vegetable juice

What are the meat and meat substitute group exchanges?

Each exchange of a lean meat listed below contains about 7 grams of protein, 0 to 3 grams of fat, and 45 calories. The meat and meat substitutes food group does not contain any carbohydrates. Medium and high-fat meats have more calories.

• 1 ounce of chicken or turkey without skin, or 1 ounce of fish (not breaded or fried)
• 1 ounce of lean beef, pork, or lamb
• 1-inch cube or 1 ounce of low-fat cheese
• 2 egg whites or ¼ cup of egg substitute
• ½ cup of tofu

What are the sweets, desserts, and other carbohydrate group exchanges?

• Sweets and other desserts: Each exchange has about 15 grams of carbohydrate .
  • 1 ounce of angel food cake or 2-inch square cake (unfrosted)
  • 2 small cookies
  • ½ cup of sugar-free, fat-free ice cream
  • 1 tablespoon of syrup, jam, jelly, table sugar, or honey
• Combination foods:
  • 1 cup of an entrée, such as lasagna, spaghetti with meatballs, macaroni and cheese, and chili with beans (each serving counts as 2 carbohydrate exchanges )
  • 1 cup of tomato or vegetable beef soup (each serving counts as 1 carbohydrate exchange )

What are the fat group exchanges?

Each exchange contains 5 grams of fat and 45 calories.

• 1 teaspoon of oil (such as canola, olive, or corn oil)
• 6 almonds or cashews, 10 peanuts, or 4 pecan halves
• 2 tablespoons of avocado
• ½ tablespoon of peanut butter
• 1 teaspoon of regular margarine or 2 teaspoons of low-fat margarine
• 1 teaspoon of regular butter or 1 tablespoon of low-fat butter
• 1 teaspoon of regular mayonnaise or 1 tablespoon of low-fat mayonnaise
• 1 tablespoon of regular salad dressing or 2 tablespoons of low-fat salad dressing

What are free foods?

The foods on this list are called free foods because they have very few calories. Free foods usually do not increase your blood sugar if you limit them.

• 1 tablespoon of catsup or taco sauce
• ¼ cup of salsa
• 2 tablespoons of sugar-free syrup or 2 teaspoons of light jam or jelly
• 1 tablespoon of fat-free salad dressing
• 4 tablespoons of fat-free margarine or fat-free mayonnaise
• Sugar-free drinks: diet soda, sugar-free drink mixes, or mineral water
• Low-sodium bouillon or fat-free broth
• Mustard
• Seasonings such as spices, herbs, and garlic
• Sugar-free gelatin without added fruit

What other healthy nutrition guidelines should I follow?

• Limit drinks with sugar substitutes. Your dietitian or healthcare provider will encourage you to drink water. Water helps your kidneys to function properly. Ask how much water you should drink every day.
• Eat more fiber. Choose foods that are good sources of fiber, such as fruits, vegetables, and whole grains. Cereals that contain 5 or more grams of fiber per serving are good sources of fiber. Legumes such as garbanzo, pinto beans, kidney beans, and lentils are also good sources.
• Limit fat. Ask your dietitian or healthcare provider how much fat you should eat each day. Choose foods low in fat, saturated fat, trans fat, and cholesterol. Examples include turkey or chicken without the skin, fish, lean cuts of meat, and beans. Low-fat dairy foods, such as low-fat or fat-free milk and low-fat yogurt are also good choices. Omega-3 fatty acids are healthy fats that are found in canola oil, soybean oil and fatty fish. Salmon, albacore tuna, and sardines are good sources of omega 3 fatty acids. Eat 2 servings of these types of fish each week. Do not eat fried fish.
• Limit sugar. Sugar and sweets must be counted toward the carbohydrate exchanges that you can have within your meal plan. Limit sugar and sweets because they are usually also high in calories and fat. Eat smaller portions of sweets by sharing a dessert or asking for a child-size portion at a restaurant.
• Limit sodium (salt) to about 2,300 mg per day. You may need to eat even less sodium if you have certain medical conditions. Foods high in sodium include soy sauce, potato chips, and soup.
• Limit alcohol. Ask your healthcare provider if it is safe for you to drink alcohol. If alcohol is safe for you to have, eat a meal when you drink alcohol. If you drink alcohol on an empty stomach, your blood sugar may drop to a low level. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men aged 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 5 ounces of wine, 12 ounces of beer, or 1½ ounces of liquor.

What else can I do to manage diabetes?

• Control your blood sugar level. Test your blood sugar level regularly and keep a record of the results. Ask your healthcare provider when and how often to test your blood sugar. You may need to check your blood sugar level at least 3 times each day.
• Talk to your healthcare provider about your weight. Ask if you need to lose weight, and how much you need to lose. If you are overweight, you may need to make other changes to lose weight. Ask your healthcare provider to help you create a weight loss program.
• Get regular physical activity. Physical activity can help decrease your blood sugar level. It can also help to decrease your risk for heart disease and help you lose weight. Adults should have moderate intensity physical activity for at least 150 minutes every week. Spread the amount of activity over at least 3 days a week. Do not skip more than 2 days in a row. Children should get at least 60 minutes of moderate physical activity on most days of the week. Examples of moderate physical activity include brisk walking, running, and swimming. Do not sit for longer than 30 minutes. Work with your healthcare provider to create a plan for physical activity.

When should I call my doctor?

• You have high blood sugar levels during a certain time of day, or almost all of the time.
• You often have low blood sugar levels.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Discuss treatment options with your healthcare provider to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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